tooth[인터뷰] Director Choi Seung-wook, a specialist in burn surgery
toothScars like ‘The Glory’ Moon Dong-eun, permanent and difficult to remove
toothLike the main character in the play, there are many cases of burning and constantly complaining of itching.
In the Netflix drama ‘The Glory’, Moon Dong-eun (Song Hye-kyo) is scalded and burned by Park Yeon-jin (Lim Ji-yeon), the ringleader of school violence. The burns from that time remain as scars all over her body, and the main character scratches the scars as if they are still itchy even after 17 years have passed. Do burn scars actually itch for a long time? Is there any way to erase scars from burns? While watching the drama, she met burn surgeon Dr. Choi Seung-wook (Dodam Surgery Clinic, Samsung Seoul) to discuss the questions she had about burns.
Director Choi Seung-wook, a specialist in burn surgeryㅣSource: Samsung Seoul Dodam Surgery Clinic
Q. How serious is Moon Dong-eun’s burn in the drama?
A burn is damage to the skin caused by a hot medium. The skin is divided into the epidermis layer, dermis layer, and muscle layer. If only the epidermis is damaged, it is 1st degree, if the skin surface and dermis are damaged, it is 2nd degree, if the subcutaneous fat layer is also damaged, it is 3rd degree, and if the muscle layer and bones are also damaged, it is classified as 4th degree burn.
Moon Dong-eun’s burns in the drama appear to be at least Shim Jae-seong’s 2nd to 3rd degree burns. Deep second-degree burns refer to a state in which the nerve layer that feels pain is damaged.
Q. Why do burn scars recover unevenly?
First, whether or not scarring occurs after a burn is determined by various factors such as the location and depth of the wound, the patient’s underlying disease, infection, and treatment. In general, burns of the second degree or higher that damage the dermal layer are likely to remain as scars. This is because when the dermal layer is damaged, collagen constituting this layer is regenerated, and in the process, fibroblasts synthesizing collagen overproliferate, causing hypertrophic scars and contractures. At this time, unlike the undamaged area, the overproliferated area protrudes and the skin surface becomes bumpy.
Wounds are healed through an inflammatory phase, a proliferation phase, and a maturation phase. If the inflammatory phase, which cleans the wound, and the proliferation phase, in which regenerated epithelial cells are created, are prolonged, melanocytes may be excessively produced, resulting in pigmentation.
Q. Do you think it is possible to remove the scars of the main character in the play?
Hyperpigmentation may take a long time, but it can be improved to some extent. However, hypertrophic scars such as Moon Dong-eun’s are permanent and difficult to remove. Many people wonder if it can be removed with surgery or laser, but surgery only improves scars to some extent, but it is impossible for burnt skin to return to normal skin before damage. Functional abnormalities, contractures, etc. can be corrected with surgery.
Hypertrophic scars are permanent and difficult to removeㅣSource: Netflix drama ‘The Glory 2’ trailer
Q. Is Moon Dong-eun scratching her burn scars because it is itchy?
When the wound is completely healed, the body sends a signal to stop regenerating the skin any further. However, if this signal is not transmitted properly, a substance called histamine is continuously released, which causes itching in the wounded area. Taking an antihistamine or injecting an injectable drug called triamcinolone into the affected area can relieve itching.
In the drama, there is a scene where young Moon Dong-eun lies on the roof in the snow and rubs her scars with her eyes. Cooling the itchy area like this reduces the secretion of histamine and improves the itching symptoms. However, if the wound is still healing, never put snow or ice directly on the skin. This is because the damage to the wound can be severe.
Q. What should I have done first aid before scarring?
Burns make our skin irreparable, so once scars are formed, it is very difficult to get rid of them. Therefore, it is important to prevent scarring in the first place.
Most fetal wounds heal without scarring because inflammatory reactions rarely occur within the fetal body. Minimizing the inflammatory response is an important key to preventing scar formation. The possibility of scarring can be reduced by washing the wound site thoroughly with saline and then covering it with a wet dressing. Even after the wound has healed, it is also important to provide enough moisture and protection until the skin stabilizes.
“Burns can happen to anyone”
Burns can happen to anyone as a result of a momentary mistake. Recently, the number of cases of daily burns in the home is increasing. Even minor burns can leave scars, so don’t think it’s irrelevant to you, but it’s good to know first aid and the nearest burn treatment hospital.
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